BioMed Central
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Journal of Occupational Medicine
and Toxicology
Open Access
Case report
Appendectomy due to lead poisoning: a case-report
S Mohammadi*
1
, AH Mehrparvar
2
and M Aghilinejad
1
Address:
1
Department of Occupational Medicine and Occupational Medicine Research Center of Iran University of Medical Sciences, Shaheed
Hemmat highway, Tehran, Iran and
2
Department of Occupational Medicine, Yazd University of Medical Sciences, Yazd, Iran
Email: S Mohammadi* - [email protected]; AH Mehrparvar - [email protected];
M Aghilinejad - [email protected]
* Corresponding author
Abstract
Background: Lead poisoning is a common occupational health hazard in developing countries and
many misdiagnoses and malpractices may occur due to unawareness of lead poisoning symptoms.
Case presentation: We report a case of occupational lead poisoning in an adult battery worker
with abdominal colic who initially underwent appendectomy with removal of normal appendix.
Later on he was diagnosed with lead poisoning and was treated appropriately with lead chelator
(CaNa
2

(pathology revealed normal tissue of appendix) without
any improvement in symptoms. He has also had other
symptoms including headache, lethargy, fatigue, irritabil-
ity, insomnia, muscle pain (especially in the legs), consti-
Published: 17 October 2008
Journal of Occupational Medicine and Toxicology 2008, 3:23 doi:10.1186/1745-6673-3-23
Received: 27 June 2006
Accepted: 17 October 2008
This article is available from: http://www.occup-med.com/content/3/1/23
© 2008 Mohammadi et al; licensee BioMed Central Ltd.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0
),
which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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pation, decreased libido, nausea, vomiting, tremor, loss of

-
EDTA 1 g Bid for 5 days. During treatment his renal func-
tion was evaluated on a daily basis. After starting the treat-
ment his symptoms improved and he was discharged
from hospital. After 2 weeks his blood lead level was 38.3
μg/dl. Upon complete recovery he returned to his job at
his former workplace.
Discussion
Lead intoxication is highly prevalent among persons
chronically over-exposed to lead. Symptoms include
arthralgia, myalgia, headache, weakness, depression, loss
of libido, impotence, and vague gastrointestinal prob-
lems. [3] The first gastrointestinal symptoms begin to
appear at blood lead level around 80 μg/dl. They consist
of loss of appetite, digestive disturbances, epigastric dis-
comfort after meals, and either constipation or diarrhea.
When the blood lead level exceeds 100 μg/dl, the likeli-
hood of more severe symptoms increases. These include
occasional or frequent abdominal colic and severe consti-
pation. If exposure does not stop, classic lead colic devel-
ops [4], which often results in inappropriate laparatomy.
[5]
In our country, the main sources of occupational lead poi-
soning are battery-manufacturing plants, lead smelting
plants, and steel plants. We do not have any specific limit
values and use ACGIH-TLVs as regulatory measures for
blood lead (50 μg/dl in two occasions needs removal
from work).
Our patient worked in a battery-manufacturing plant and
had typical symptoms and signs of lead poisoning; he was

icine 3rd edition. Edited by: Zenz C. USA: Mobsy; 1994:506-548.
5. Kehoe RA: Occupational lead poisoning: Chemical signs of the
absorption of lead. J Occup Med 1972, 14(5):390-396.